Larry Smarr discusses his decade-long journey of self-quantification by tracking over 100 biomarkers in his blood and stool using various sensors and devices. This led to insights into his health and formed the basis for an emerging personalized wellness industry. The cost of sequencing has fallen dramatically, enabling analysis of one's genome and microbiome to gain health insights. This represents a disruption of the current healthcare system with citizens generating their own health data to partner with doctors.

1. “The Quantified Self: From Idiosyncratic Hobby
to an Emerging Growth Industry”
Invited Lecture
Science & Technology Discovery Series
Technology Alliance
Seattle, WA
October 10, 2014
Dr. Larry Smarr
Director, California Institute for Telecommunications and Information Technology
Harry E. Gruber Professor,
Dept. of Computer Science and Engineering
Jacobs School of Engineering, UCSD
http://lsmarr.calit2.net
1

2. Abstract
Starting a decade ago I began to increasingly quantify the changes of my body over time. Like
most people I started with tracking my weight, then added diet and exercise apps and gadgets.
But five years ago I began to go deeper - tracking over 100 biomarkers in my blood and stool.
Eventually, I added in sequencing my human genome and my gut microbiome. All of this
transition to Big Data became possible because of continuing technological exponentials. While
my "hobby" seemed quirky to many in the past, an emerging growth industry, based on these
practices, is developing with the goal of sustaining wellness, while fundamentally disrupting the
current "sick care" industry. Simultaneously, research is accelerating in the same field, as
exemplified by Lee Hood's 100 Person Wellness Project, headquartered in Seattle's Institute for
System Biology. As one of the Pioneer 100, I will review some of the project's insights for
personalized action to improve and sustain your health.

3. Calit2 Has Had a Vision of
“the Digital Transformation of Health” for a Decade
• Next Step—Putting You On-Line!
www.bodymedia.com
– Wireless Internet Transmission
– Key Metabolic and Physical Variables
– Model -- Dozens of Processors and 60 Sensors /
Actuators Inside of our Cars
• Post-Genomic Individualized Medicine
– Combine
– Genetic Code
–Body Data Flow
– Use Powerful AI Data Mining Techniques
The Content of This Slide from 2001 Larry Smarr
Calit2 Talk on Digitally Enabled Genomic Medicine

4. My Decade Long Journey to Being a Quantified Self:
By Measuring the State of My Body and “Tuning” It
Using Nutrition and Exercise, I Became Healthier
I Arrived in La Jolla in 2000 After 20 Years in the Midwest
2000
Age
41
2010
Age
61
1999
1989
Age
51
1999
I Reversed My Body’s Decline By
Quantifying and Altering
Nutrition, Exercise, Sleep, and Stress
http://lsmarr.calit2.net/repository/LS_reading_recommendations_FiRe_2011.pdf

5. My Quantifying Experiments Became Public
in Seattle in 2010

6. I Used a Variety of Emerging Personal Sensors
To Quantify My Body & Drive Behavioral Change
Withings/iPhone-
Blood Pressure
Zeo-Sleep
Azumio-Heart Rate
MyFitnessPal-
Calories Ingested
FitBit -
Daily Steps &
Calories Burned
Withings WiFi Scale -
Daily Weight

7. Wireless Monitoring
Helped Drive My Exercise Goals
Since Starting November 3, 2011
Total Distance Tracked 3,223 miles = San Diego to Bangor, ME
Total Vertical Distance Climbed 107,000 ft. = 3.7 Mt. Everest
Using Polar Chest Strap
My Resting Heartrate During Elliptical Workouts
Fell from 70 to 40!

8. The Self-Monitoring Business
Has Reached Market Takeoff
• MyFitnessPal
– 40 Million Users
– Aug 2013 Raised $18M Series A, Led by Kleiner Perkins
• Fitbit
– Has Raised ~$70M
• BodyMedia Was Bought by Jawbone
– For ~$100M
• Zeo Sleep Monitor
– Closed Down in 2013
More Mergers Likely as the Shakeout Continues

9. In 2013 QS Went Mainstream

10. 2014 is the Year of the Sensor Integrated Dashboard
Combined with Coaching
My RevUp! Age Has
Decreased to 60
My Physical Age is 66
Source: Samir Damani, MD Revolution

11. Deep Learning Will Provide
Personalized Assistants to Coach Us to Wellness
Where Medicine Coaching is Now
Where Wellness Coaching is Going

12. The Emergence of P4 Medicine --
Predictive, Preventive, Personalized, Participatory
Systems Biology &
Systems Medicine
Consumer-Driven
Social Networks
P4
MEDICINE
Digital Revolution
Big Data
How Will the Quantified Consumer
Be Integrated into Healthcare Systems?
Source: Lee Hood, ISB

13. From One to One Billion Data Points Defining Me:
Big Data Coming to the Electronic Medical Record (EMR)
Human & Microbial Genome
Billion: My Full DNA,
MRI/CT Images
Million: My DNA SNPs,
Zeo, FitBit
One: Hundred: My Blood Variables
WeigMhyt Weight
Blood
Variables
SNPs
Today’s EMR
Tomorrow’s EMR

14. Visualizing 5-10 Year Time Series of 150 Blood & Stool
Variables Led Me to Discover a Chronic Disease
Calit2 64 megapixel VROOM

15. Early Adopting MDs Are Creating Partnerships
with Their Quantified Patients
• “The 100 participants will be guided on this 9-month
journey by a coach and when necessary,
be referred to their own health care practitioners.”
• The data sets that will be evaluated include:
– Self-Tracking Devices
– Medical History, Traits, Lifestyle
– Blood, Urine, Saliva
– Gut Microbiome
– Whole Genome Sequencing
Will Grow to 1000, then 10,000
There are 8760 Hours in a Year
One of These Hours You Are With a Doctor…
The Other 8759 Hours Are Up to You!
https://pioneer100.systemsbiology.net/

16. I Titrate My Supplements by Measuring
The Amounts Inside of My Red Blood Cells
Increase Cu
Decrease Mg
Maintain Dose
Test Results from Genova Diagnostics,
Via Lee Hood’s Pioneer 100 Program

17. Healthcare Must Include a Vast Amount
of Microbial Information That is Not in Today’s Medicine
Your Body Has 10 Times
As Many Microbe Cells As Human Cells
99% of Your
DNA Genes
Are in Microbe Cells
Not Human Cells
Inclusion of the Microbiome
Will Radically Change Medicine

18. The Cost of Sequencing a Human Genome
Has Fallen Over 10,000x in the Last Ten Years
This Has Enabled Sequencing of
Both Human and Microbial Genomes

19. Using Supercomputing Allows Comparison of
the Relative Abundance of 200 Gut Microbe Species
Comparing 3 LS Time Snapshots (Left)
with Healthy, Crohn’s, UC (Right Top to Bottom)
Calit2 VROOM-FuturePatient Expedition

20. Using Microbiome Profiles to Survey 155 Subjects
for Unhealthy Candidates

21. Comparison Across the Pioneer 100 Gut Microbiomes
Allows For Early Detection of Deviation From Health
A Few With High %
Proteobacteria
or Verrucomicrobia
Only 6 With Bacteriodetes <20%

22. Inexpensive Consumer 16S Time Series of Microbiome
Allows Similar Analysis Through Ubiome
Data source: LS (Yellow Lines Stool Samples);
Sequencing and Analysis Ubiome

23. There is a Huge New Field of Products Coming
Which Enable You to “Garden” Your Microbiome
“I would like to lose the language of warfare,”
said Julie Segre, a senior investigator at
the National Human Genome Research Institute.
”It does a disservice to all the bacteria
that have co-evolved with us
and are maintaining the health of our bodies.”
Will Medical Foods Provide New Tools
for Altering Gut Microbiome?

24. Everything I Discussed Can Be Done by Startups -
Outside of the Traditional Medical Complex
Blood Variable Time Series Stool Variable Time Series
Human Genetic Variations MicrobiomeTime Series

25. World’s Youngest Female Billionaire
Aims to Disrupt the Medical Testing Industry

26. A Looming Disruption In Healthcare Systems
From Personalized Medicine
• Citizens Create Vast Datasets Outside of EMRs
• Post-“Watson” Personalized Coaches
• Doctors Must Partner with Super-Informed Patients
• Increased Use of Supplements and Medical Foods
• From Treating Sickness to Maintaining Wellness

27. Thanks to Our Great Team!
UCSD Metagenomics Team
Weizhong Li
Sitao Wu
Calit2@UCSD
Future Patient Team
Jerry Sheehan
Tom DeFanti
Kevin Patrick
Jurgen Schulze
Andrew Prudhomme
Philip Weber
Fred Raab
Joe Keefe
Ernesto Ramirez
JCVI Team
Karen Nelson
Shibu Yooseph
Manolito Torralba
SDSC Team
Michael Norman
Mahidhar Tatineni
Robert Sinkovits
UCSD Health Sciences Team
William J. Sandborn
Elisabeth Evans
John Chang
Brigid Boland
David Brenner